The practical value of prediction: a semireliable assistant. Surgical Oncology

摘要

The proposed utility of a nomogram is to assist decision making for complete axillary lymph node dissection (CLND) in breast cancer patients who have a positive sentinel lymph node (SLN)- According to the American Joint Committee on Cancer Cancer Staging Manual (sixth edition, 2002), a positive SLN is defined as tumor deposits > .2 mm. Isolated tumor cells, clusters smaller than .2 mm, are classified as NO- Of all patients with a positive SLN, about 30% to 50% will have additional non-SLNs that contain tumor cells detectable by hematoxylin and eosin. The size of these metastases is not well documented since only in the most recent update of the American Joint Committee on Cancer staging system has size been relevant. The standard of care is to perform CLND on all patients who have positive SLNs. Accurately predicting which patients with a positive SLN are the 50% to 70% with no additional nodal disease might spare them the morbidity of a CLND.